Globally, the number of new HIV infections as well as deaths related to AIDS have dropped to their lowest levels since the epidemic reached its peak, according to a new report issued by UNAIDS (Joint United Nations Program on HIV/AIDS), titled 2011 UNAIDS World AIDS Day report. The authors state that this has been a game-changing year for worldwide fight against AIDS.
In comparison to 1997, the rate of new HIV infections has dropped by 21%, while AIDS-related deaths have fallen by 21% since 2005.
Michel Sidibé, Executive Director of UNAIDS, said:
"Even in a very difficult financial crisis, countries are delivering results in the AIDS response. We have seen a massive scale up in access to HIV treatment which has had a dramatic effect on the lives of people everywhere."
According to estimates by the World Health Organization (WHO) and UNAIDS, 6.6 million of the 14.2 million individuals who are eligible for treatment in developing nations had access to antiretroviral therapy last year, i.e. 47% of the total. This represents 1.35 million more people than the year before.
The report also reveals that HIV treatments are having a considerable impact on bringing down new HIV infection numbers, according to some early signs.
Botswana as an exampleThe patterns of sexual behavior in Botswana have stayed pretty much the same since 2000. In 2000 less than 5% of HIV-positive individuals had access to treatment, compared to over 80% since 2009.
The number of newly diagnosed HIV infections has fallen by over 2/3 since the end of the 1990s. According to reliable data, current rates of new HIV infections in the country are between 30% to 50% lower than they would have been had antiretroviral therapy not been available.
People infected with HIV who are being treated with antiretroviral medications have virtually undetectable levels of HIV, meaning their chances of transmitting HIV to uninfected sexual partners are considerably lower.
UNAIDS cited recent studies which showed that HIV transmission among couples can be up to 96% lower if the infected person is being treated with antiretrovirals.
Global numbersAt the end of 2010:
- Between 31.6 million and 25.2 million individuals lived with HIV globally
- Between 2.4 million and 2.9 million new infections were reported worldwide in 2010
- Between 1.6 million and 1.9 million people died from an AIDS-related illness in 2010 globally
New HIV-infectionsSubSaharan-Africa - The new HIV infection rate worldwide has either gone down or stabilized, the authors informed. Rates have fallen by 27% in sub-Saharan Africa since 1997, when the epidemic was at its peak. In South Africa there has been a 27% fall.
The Caribbean - compared to 2001, new annual infection rates have fallen by a third. In Jamaica and the Dominican Republic there has been a 25% drop during the same period.
South and South-East Asia - new HIV infection rates fell by over 40% between 2006 and 2010. The rate in India went down by 56%.
Where rates continue to riseThe battle is far from over, the authors explain. In Oceania, the Middle-East, North Africa, Central Asia and Eastern Europe, the number of new HIV infections continues to rise. In the rest of the world (parts not mentioned so far) rates have remained stable.
Why have rates dropped?People's changing sexual behaviors have also helped bring down the new HIV infection rate, especially among young individuals. Examples include:
- Sexually active people having fewer sexual partners
- The use of condoms has increased considerably
- People seem to be becoming sexually active later
Without changes in people's sexual behavior in Zimbabwe over the last 20 years, there would have been 35,000 extra infections every year.
More circumcisions are also thought to have contributed to falling new HIV infection rates. After voluntary circumcisions were scaled up in Nyanza province, Kenya, rates dropped significantly. If 20 million males are circumcised throughout Eastern Europe and Southern Africa, a further 2.4 million new HIV infections could be averted by 2015.
400,000 children in developing nations are not HIV positive because of increased access to antiretroviral medications which began in 1995. In 2010, about 48% of all HIV-positive pregnant mothers had access to effective therapy to prevent their child from becoming infected.
New high-impact, evidence-based, high-value strategiesA new framework for AIDS investment, mapped by UNAIDS, focuses on evidence-based, high-value and high-impact strategies.
"The investment framework is community driven not commodity driven. It puts people at the centre of the approach, not the virus."
UNAIDS says this new investment approach should achieve spectacular results:
- 12.2 million or more new HIV infections would be prevented, of which 1.9 million would have been children (between 2011 and 2010)
- The number of AIDS-related deaths would be 7.4 million lower during the same period
- Concentrated interventions for high risk groups, such as sex workers, the clients of sex workers, individuals who inject drugs, and men who have sex with men
- Focusing on children so they do not become infected
- Programs which focus on sexual behavior change
- The promotion and distribution of condoms
- Care for those living with HIV, and support
- Voluntary male circumcision in countries with a high HIV rate
In order to do all this, funding needs to be increased to between $22bn and $24bn in 2014. About $15 billion was available for AIDS response in developing nations. Donor funds have dropped, mainly because there is less money to give away; many developed countries are experiencing economic difficulties. However, for all this to have been worth it, contributions must continue.
Written by Christian Nordqvist